Managing Hypertension with the DASH Diet

What you eat can help lower your blood pressure and reduce your risk for stroke and heart disease.

One such diet, the Dietary Approaches to Stop Hypertension (DASH) diet, has been shown to reduce blood pressure. This diet is low in saturated fat, cholesterol, and total fat. The diet emphasizes fruits, vegetables, and low-fat dairy products.

According to the National Heart, Lung, and Blood Institute (NHLBI), your blood pressure can be unhealthy even if it stays only slightly above 120/80 mm Hg. The higher above that level, the greater your health risk. Over time, high blood pressure makes your heart work too hard, which can cause stroke, hardening of the arteries, heart failure, kidney disease, and even blindness.

Why this diet works

Why is the DASH diet so effective at reducing blood pressure?

It combines many nutrients that have been shown to be beneficial in reducing blood pressure. Those nutrients include calcium, potassium, magnesium, protein, and fiber, as well as lower total fat and saturated fat.

The DASH diet is naturally low in salt. The American Heart Association recommends that everyone — no matter the age, ethnic background, or medical condition — consume less than 1,500 mg of sodium a day. 

Further, following the DASH diet may delay your need to take hypertension medication, and may even keep you from needing to take it at all. And if you're already on medication, it may help you reduce the amount you take.

Doing the DASH

The DASH diet is a 2,000-calorie diet that includes:

  • Six to eight daily servings of grains and grain products, such as whole wheat bread, cereal, oatmeal, crackers, unsalted pretzels, and popcorn. A serving size is one slice of bread, one cup of ready-to-eat cereal, or a half-cup of rice, pasta, or cereal.

  • Four to five daily servings of vegetables — the darker in color, the better. A serving size is one cup of raw leafy vegetables, a half-cup of cooked vegetables, or six ounces of vegetable juice.

  • Four to five daily servings of fruit. A serving is one medium fruit, quarter-cup of dried fruit, half-cup of fresh, frozen or canned fruit, or six ounces of fruit juice.

  • Two or three daily servings of low-fat or fat-free dairy products. A serving is eight ounces of milk, one cup of yogurt, or 1½ ounces of cheese.

  • Six or fewer daily servings of lean meat, poultry, or fish. A serving is one ounce of cooked meats, skinless poultry, or fish.

  • Four to five servings per week of nuts, seeds, and dry beans. A serving is one-third cup or 1½ ounces of nuts, one tablespoon or half-ounce of seeds, or half-cup cooked dried beans.

  • Two to three small daily servings of fats and oils, such as olive oil and low-fat salad dressing. A serving is one teaspoon soft margarine, one tablespoon low-fat mayonnaise, two tablespoons light salad dressing, or one teaspoon vegetable oil.

  • Five or fewer servings per week of sweets, such as maple syrup, sorbet, or gelatin. A serving is one tablespoon sugar, one tablespoon jelly or jam, half-ounce jellybeans, or eight ounces of lemonade.

Although the DASH diet isn't designed for weight loss, it can easily promote it if you reduce the number of servings you consume. Most of the food the diet features is low in energy density, which means it's big on volume and low in calories.

Still, there are aspects to the DASH diet that may not be easy to replicate. For one, it's packed with dark-colored fruits and vegetables, so be prepared to be choosier at the supermarket. Also, if it's vastly different from what you normally eat, it may be hard to adjust.

If you're serious about following the diet, it's a good idea to work with a registered dietitian (R.D.) for support and guidance. (For the names of R.D.s in your area who are familiar with the DASH diet, visit the Academy of Nutrition and Dietetics.)

Moving forward

If you decide to go it alone, adopt the DASH diet gradually. By doing so, you'll be more apt to stick to it long-term.

For example, add one more serving of vegetables at lunch and dinner if you eat only one or two servings a day now. You might also add fruit to meals and snacks if you now only have juice for breakfast. In addition, slowly increase your dairy products to three servings per day. Try drinking skim milk with lunch or dinner, instead of soda, alcohol, or tea.

To maximize the impact of the DASH, lose weight if you need to and exercise regularly. Thirty minutes of moderate exercise four to five days a week is recommended. 

More dish on the DASH

"The DASH Eating Plan" is a 24-page online guide published by the NHLBI. It offers a reader-friendly explanation of high blood pressure, detailed daily servings charts to help you plan your menus, a week of suggested DASH menus, plus tips to reduce sodium.

For more information about diet and other lifestyle factors to reduce hypertension, visit Your Guide to Lowering Blood Pressure. This is another comprehensive NHLBI guide.